I would be repeating what every other comment submitted before me, so I will just add one more comment.....

Modifications to the HCBS requirements could, and should, be processed and approved through the interdisciplinary team process, and documented in the PCP.

Assuming competence is a "feel good" guidance, but not necessarily practical to a provider, especially if a guardian is already in place.

The examples given are contradictory, at best, with best practices and with licensing and human rights standards.